Validation of the new IDF-DAR risk assessment tool for Ramadan fasting in patients with diabetes. Issue 4 (April 2023)

• Record Type: Journal Article
• Authors: Mohammed, Nagi; Buckley, Adam; Siddiqui, Mohsin; Al Ahmed, Sameera; Afandi, Bachar; Hassanein, Mohamed; Lessan, Nader; Suliman, Mohamed
• Is Part Of: Diabetes & metabolic syndrome. Volume 17:Issue 4(2023)
• Publication Date: 2023-04
• Subjects: Ramadan -- Fasting -- Score -- Risk -- Diabetes; Diabetes -- Periodicals; Metabolism -- Disorders -- Periodicals; Diabetes Mellitus -- Periodicals; Metabolic Diseases -- Periodicals; Diabète -- Périodiques; Métabolisme, Troubles du -- Périodiques; Endocrinologie -- Périodiques; Diabète -- Physiopathologie -- Périodiques; Diabetes; Metabolism -- Disorders; Electronic journals; Periodicals; 616.462
• DOI: 10.1016/j.dsx.2023.102754
• Languages: English
• ISSNs: 1871-4021

Abstract

Abstract: Background: A new IDF-DAR (International Diabetes Federation - Diabetes and Ramadan Alliance) risk stratification tool was published in 2021 to better stratify the risk of Ramadan fasting in people with diabetes. Methods: We performed a prospective, survey-based study before and after Ramadan 1442/2021 to explore the ability of the new IDF-DAR risk stratification tool to predict the probability of fasting and the risk of complications from fasting in people with diabetes. Results: A pre-Ramadan assessment was completed for 659 patients who intended to fast in Ramadan; 647(98.2%) answered the post-Ramadan follow-up questionnaire. Mean age was 53.5 years and 47.9% were females. 603(91.5%) had type 2 diabetes while 56(8.5%) had type 1 diabetes. Using the IDF-DAR risk criteria at the pre-Ramadan assessment, 339(51.4%) were categorized as low-risk (score <3), 173(26.3%) as moderate-risk (score 3.5–6) and 147(22.3%) as high-risk (score >6). 94.3%, 81.1% and 76.9% patients fasted the full 30 days in the low, moderate and high risk groups respectively (p < 0.0001). Any hypoglycaemia was reported in the low, moderate and high risk groups by 6.3%, 21.9% and 35.0% respectively while severe hypoglycaemia was reported by 3(2.1%) patients in the high, 3(1.8%) in the moderate and none(0%) in the low risk groups. Hyperglycaemia (>250 mg/dL) was reported in the low, moderate and high risk groups by 2.7%, 13.0% and 23.8% respectively. Conclusion: The new IDF-DAR risk assessment tool appears to reliably predict both the ability to fast during Ramadan as well as the likelihood of getting hypoglycaemia or hyperglycaemia. Highlights: The IDF-DAR 2021 guidelines introduced a new tool to better risk stratify people with diabetes during Ramadan fasting. The new risk assessment tool appears to reliably predict the ability to fast during Ramadan. The tool is also effective in predicting the risk of hypo and hyperglycaemia in fasting adults with diabetes.